Healthcare Provider Details

I. General information

NPI: 1093635997
Provider Name (Legal Business Name): BRIGHTER WINS ABA OF MO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 BONHOMME AVE
CLAYTON MO
63105-1911
US

IV. Provider business mailing address

7777 BONHOMME AVE
CLAYTON MO
63105-1911
US

V. Phone/Fax

Practice location:
  • Phone: 732-378-9624
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: AMANDA COHEN
Title or Position: MANAGER
Credential:
Phone: 732-378-9624